How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $912.01 | Professional | None | $575.44 | $575.44 | $912.01 |
BCBS Alabama Setting Facility Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Facility | None | $7,762.47 | $7,762.47 | $7,762.47 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,122.02 Typical High $1,380.38 | Facility | None | $489.78 | $1,122.02 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $676.08 | Professional | None | $389.05 | $467.74 | $676.08 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,073.80 | Facility | None | $758.58 | $1,737.80 | $4,073.80 |
United Setting Professional Modifier None Typical Low $275.42 Median $467.74 Typical High $776.25 | Professional | None | $275.42 | $467.74 | $776.25 |
8 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $288.40 Typical High $457.09 | Professional | 52 · Reduced service | $288.40 | $288.40 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $181.97 | Professional | 53 · Discontinued | $114.82 | $114.82 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $691.83 | Professional | 54 · Surgery only | $426.58 | $426.58 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $138.04 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $91.20 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $645.65 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $11,481.54 Median $11,748.98 Typical High $11,748.98 | Facility | 50 · Both sides | $11,481.54 | $11,748.98 | $11,748.98 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $407.38 Median $562.34 Typical High $758.58 | Professional | 32 · Mandated service | $407.38 | $562.34 | $758.58 |
Where Alabama sits
The same service costs 4.7 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Alabama· 28th of 51
$575
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.